Healthcare Provider Details

I. General information

NPI: 1710276290
Provider Name (Legal Business Name): ASHLEIGH GAIL DESCHENES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 STILLWATER AVE APT 1
OLD TOWN ME
04468-1472
US

IV. Provider business mailing address

33 STILLWATER AVE APT 1
OLD TOWN ME
04468-1472
US

V. Phone/Fax

Practice location:
  • Phone: 207-343-1100
  • Fax:
Mailing address:
  • Phone: 207-343-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: